Managing your diet is crucial when you’re looking to gain control over symptoms related to histamine intolerance. The world of food is constantly evolving, with ongoing research refining our understanding of how foods affect us, especially concerning food intolerances like Histamine Intolerance (HIT). At foods.edu.vn, we aim to provide you with the latest insights and practical guidance.
Remember, food lists, including the one provided here, serve as guidance, not definitive rules. Individuals with HIT often experience multiple intolerances. Therefore, it’s strongly advised to seek a professional diagnosis from a doctor and consult with a registered dietitian before starting any elimination diet. Self-management without professional guidance can be complex and may not address underlying health issues.
If you follow a carefully planned elimination diet under professional supervision, you may start noticing positive changes in your symptoms within approximately four weeks. HIT is characterized by varying individual thresholds, or tolerance levels to histamine. After a successful elimination phase, the next important step is to work with your dietitian to identify your personal threshold. The goal is to gradually increase your tolerance over time, expanding your dietary choices while managing symptoms effectively. Improving your quality of life through dietary adjustments is achievable with the right approach and support.
It’s vital to understand that managing histamine intolerance is about eating foods that are low in histamine relative to your individual tolerance. It’s also important to remember that a truly “histamine-free diet” is not possible. Histamine is naturally occurring in many foods, and the goal is to minimize intake from high-histamine sources and manage your body’s overall histamine load.
Here are some general guidelines to consider regarding histamine in foods:
- Limit Canned and Ready-Made Meals: These often contain preservatives and may have higher histamine levels due to processing and storage.
- Reduce or Avoid Fermented and Aged Foods: This category includes aged cheeses, alcoholic beverages, yeast-containing products, and improperly stored fish. Fermentation processes naturally increase histamine content.
- Histamine Levels Fluctuate: The histamine content in food is not static. It varies depending on ripeness, aging, fermentation, and hygiene practices during food handling and preparation.
- Prioritize Freshness: Whenever possible, choose fresh produce and meats. Fresh foods generally have lower histamine levels compared to older or processed options.
- Refrigerate Promptly: Don’t leave food, especially meat and fish, at room temperature for extended periods. Histamine levels can increase as food sits out.
- Maintain Kitchen Hygiene: A clean kitchen environment helps minimize bacterial growth, which can contribute to histamine formation in food.
- Know Your Threshold: Everyone’s tolerance to histamine is different. Identifying your personal threshold is key to managing your diet effectively.
- Consult a Dietitian: A registered dietitian specializing in food intolerances can help you create a balanced and personalized low-histamine diet plan tailored to your needs.
- Learn to Cook Fresh Meals: Cooking from scratch allows you to control the ingredients and freshness of your meals, significantly aiding in histamine management.
Foods Generally Considered Low in Histamine:
- Fresh Meat: This includes freshly butchered, cooled, frozen, or fresh beef, pork, and lamb.
- Certain Fresh and Frozen Fish: Opt for white fish like hake and plaice, and trout, when very fresh or frozen immediately after catch.
- Fresh Chicken: Choose fresh, cooled, or frozen chicken.
- Eggs: Cooked eggs are generally well-tolerated.
- Most Fresh Fruits: With the exception of plantains and fruits listed as histamine liberators below, most fresh fruits are considered low in histamine.
- Most Fresh Vegetables: Avoid tomatoes, eggplant, and spinach, which are higher in histamine or histamine liberators. Most other fresh vegetables are suitable.
- Grains: Include rice noodles, white bread, rye bread, rice crisp bread, oats, puffed rice crackers, millet flour, and pasta.
- Fresh Pasteurised Milk and Milk Products: Fresh milk and some dairy products can be included in moderation depending on individual tolerance.
- Milk Substitutes: Goat milk and sheep milk are often better tolerated than cow’s milk.
- Fresh Cream Cheese, Mozzarella, Butter: Ensure these are fresh and have not developed rancidity.
- Most Cooking Oils: Choose oils like olive oil and coconut oil; check individual suitability.
- Most Leafy Herbs: Use fresh herbs like parsley, basil, and thyme; check individual tolerance.
- Most Fruit Juices (Non-Citrus): Apple, pear, or grape juice (freshly made) are generally acceptable.
- Herbal Teas (Except Certain Varieties): Many herbal teas are low in histamine, but avoid black tea and mate tea.
Foods Generally Considered High in Histamine:
- Alcohol: All types of alcoholic beverages are high in histamine and also inhibit DAO.
- Eggplant: Naturally contains higher levels of histamine.
- Pickled and Canned Foods: Sauerkraut, pickles, and other preserved vegetables are high in histamine due to fermentation.
- Aged Cheeses: Hard and aged cheeses like cheddar, parmesan, and Swiss are very high in histamine.
- Smoked and Processed Meats: Salami, ham, sausages, and other smoked or cured meats are high in histamine.
- Shellfish: Shrimp, lobster, crab, and mussels are generally high in histamine.
- Beans and Pulses: Chickpeas, soy flour, and other legumes can be higher in histamine for some individuals.
- Long-Stored Nuts: Peanuts, cashews, almonds, and pistachios, especially if stored for extended periods, can develop higher histamine levels.
- Chocolate and Cocoa Products: Chocolate, cocoa powder, and products containing them are high in histamine and histamine liberators.
- Seitan: A wheat gluten-based meat substitute, can be high in histamine for some.
- Rice Vinegar: Fermented vinegars are generally higher in histamine.
- Ready Meals and Leftovers: Pre-prepared meals and leftovers are often higher in histamine.
- Salty Snacks and Sweets with Preservatives and Artificial Colourings: These can contain additives that may exacerbate histamine intolerance.
Histamine-Releasing Foods (Histamine Liberators):
- Citrus Fruits: Lemons, limes, oranges, and grapefruits can trigger histamine release in the body.
- Cocoa and Chocolate: As mentioned above, also histamine liberators.
- Nuts (Walnuts, Peanuts): Certain nuts can promote histamine release.
- Certain Fruits: Papaya, pineapples, plums, kiwi, and bananas can act as histamine liberators in some people.
- Legumes: Also histamine liberators, in addition to being potentially high in histamine.
- Tomatoes: Both high in histamine and a histamine liberator.
- Wheat Germ: Can trigger histamine release.
- Vinegar (Most Types): Except for white wine vinegar and apple cider vinegar in some cases.
- Food Additives: Benzoates, sulphites, nitrites, glutamate (MSG), and artificial food dyes are common histamine liberators.
Foods Reported to Block Diamine Oxidase (DAO) Enzyme:
- Alcohol: Significantly inhibits DAO, the enzyme that breaks down histamine.
- Black Tea: Contains compounds that can interfere with DAO activity.
- Energy Drinks: Often contain ingredients that may affect DAO function.
- Mate Tea: Similar to black tea, may inhibit DAO.
Foods with Debatable Histamine Levels:
- Yoghurt: Histamine levels depend heavily on the bacterial cultures used in fermentation. Fresh, plain yoghurt may be tolerated in small amounts by some.
- Egg White: Earlier theories suggesting egg white as a histamine releaser are largely dismissed by current research.
Other Considerations:
- Yeast: While yeast itself may not directly contain histamine, it can facilitate histamine production during food processing and fermentation. Its relevance for HIT patients is still debated.
- Yeast Extract: Reported to be very high in biogenic amines and a DAO inhibitor, making it generally unsuitable for a low-histamine diet.
An elimination diet typically lasts around 4 weeks. By this time, you should expect to experience a noticeable improvement in your symptoms. Following the elimination phase, it’s essential to work with your healthcare provider to determine your personal histamine threshold and reintroduce foods systematically to broaden your diet while managing your symptoms.
Sources:
- Food Intolerances, Histamine, FODMAPs & IBS Guide; online app by BALIZA
- nmi-Portal, (English Version: Food Intolerance Network)
- Maintz L, Novak N: Histamine and histamine intolerance, American Journal of Clinical Nutrition 2007
- Jarisch, R. “Histaminunverträglichkeit”, Thieme Verlag, 2nd Edition
